Respiratory reanimation and anaesthesia apparatus

ABSTRACT

A portable, multipurpose apparatus for anaesthesia and respiratory reanimation provided with means, for the vaporization of anaesthetic liquids and for the administration of anaesthetics and respiratory reanimation. The assembly comprises T-pieces, with a switch, for the connecting of a self-inflating bag or of a respiratory bellows ahead of the vaporizer and for connection of a respiratory bag, downstream the vaporizer; a third shutting-off T-piece, with a switch is provided with a self-occluding valve or with a soda lime canister and a self-occluding valve, united by corrugated tubes, with connections for a closed-circuit respirator bag or for a respirator for closed circuit. The portable apparatus has the pieces of the assembly and of the first administering circuit mounted on the upper cross-bar of a supporting frame for the table; in a wall version, with a lower support for the new circuit, the frame can be fixed detachably to a bar fastened in the wall.

United States Patent [191 Simionescu et al.

[ A June 4, 1974 1 RESPIRATORY REANIMATION AND ANAESTHESIA APPARATUS[73] Assignee: lndustria Tehnico-Medicala,

Bucharest, Romania 22 Filed: Apr. 6, 1972 2 1 Appl. No.: 241,559

[30] Foreign Application Priority Data Apr. 15, 1971 Romania 66588 [52]US. Cl 128/188, 128/145.5, 137/597 [51] Int. Cl A6lm 17/00 [58] Field ofSearch 128/188, 274, 196, 197,

FOREIGN PATENTS OR APPLICATIONS 1,193,522 6/1970 Great Britain 128/188Primary Examiner-Char1es F. Rosenbaum Assistant Examiner-Henry J. ReclaAttorney, Agent, or FirmKar1 F. Ross; Herbert Dubno 57 ABSTRACT Aportable, multipurpose apparatus for anaesthesia and respiratoryreanimation provided with means, for the vaporization of anaestheticliquids and for the administration of anaesthetics and respiratoryreanimation. The assembly comprises T-pieces, with a switch, for theconnecting of a self-inflating bag or of a respiratory bellows ahead ofthe vaporizer and for connection of a respiratory bag, downstream thevaporizer; a third shutting-off T-piece, with a switch is provided witha self-occluding valve orwith a soda lime canister and a self-occludingvalve, united by corrugated tubes, with connections for a closed-circuitrespirator bag or for a respirator for closed circuit. The portableapparatus has the pieces of the assembly and of the first administeringcircuit mounted on the upper cross-bar of a supporting frame for thetable; in a wall version, with a lower support for the new circuit, theframe can be fixed detachably to a bar fastened in the wall.

6 Claims, 16 Drawing Figures [56] References Cited UNITED STATES PATENTS1,710,540 4/1929 Hollander 128/274 2,407,221 9/1946 B1oomheart.. 128/1882,841,142 7/1958 Hay 128/188 3,017,881 l/l962 Smith 128/188 3,032,0575/1962 Mays 128/272 3,183,906 5/1965 Moyat 128/188 v PATENTEDJUN 4 I974-saminr7 minimums '3.814.092

I SHEEIZHF? PATENTEDJUH 41914 Q 3.814.092 sum s at 7 FIELD OF THEINVENTION The invention relates to a portable multipurpose apparatus foranaesthesia and respiratory reanimation, able to work both in thepresence and the absence of medicinal gases, for the vaporization of theanaesthetic liquids and permitting anoesthetization and reanimation.

BACKGROUND OF THE INVENTION There are known portable systems foranaesthesia and respiratory reanimation which have fixed mountings, andthe drawback of not being able to cope with the various situationsarising in daily practice, since they cannot be adapted to separatecases.

In general known portable apparatus for anaesthesia and respiratoryreanimation may be classified by the technique of feeding the medicinalgases into three groups: a. apparatus operating without an oxygensource, the vaporization of the anaesthetic being performed by the air,which is also used to carry out respiratory reanimation; b. apparatusdependent on a source of medicinal gases, permitting the performance ofrespiratory reanimation with oxygen and the administration ofanaesthesia with anaesthetic vapors and accurately dosed amounts ofoxygen and nitrogen protoxide; such apparatus cannot work without asource of medicinal gas; and c. apparatus able to work either in theabsence of medicinal gas sources or in the presence thereof; the lattersystems offer greater technical possi-. bilities and an easier handling,but have, as a rule, the disadvantage of being noradaptable to thevarious requirements occuring in daily practice and consequently have nomultipurpose character.

Conventional portable apparatus for anaesthesia and respiratoryreanimation are constructed, as a rule, with fixed circuits theincorporation technical achievement a new vaporizer, a new anaestheticcircuit calls for a complex modification of the apparatus.

In order to meet the requirements of small space, there has beenprovided a series of anaesthesia devices, fixed to the wall and fed fromthe hospital distibution with medicinal gases. Such apparatus, too,cannot have a fixed scheme and cannot ensure the continuation ofadministration of anaesthesia in the case of an accidental interruptionof the medicinal gas distribution,

Some apparatus is provided with semi-open anaesthetic circuits, endowedwith self-occluding (selfcleaning) valves, so-called inflating valves";these valves are used in apparatus that permits respiratory reanimation.In the case of semi-open circuits the selfoccluding valve is by theinspiratory branch to the corrugated tube for gas, and by the transversebranch to the face-mask or to the endotracheal tube, while itsexpiratory branch remains free.

- Finally, mention must be made here also of the various known types ofadministering circuits: the Sword filtering circuit, the Waters to andfro circuit, theserniopen circuits of Magill, Kuhn, Digby-Leigh, Ayre,etc.

SUMMARY OF THE INVENTION The present invention relates to a portableanaesthesia and respiratory reanimation apparatus comprising an assemblyof elements for the feeding of the circuits with gas or air, for thevaporization of anaesthetic liquids and the mixing and transportthereof, and circuits with units for respiratory reanimation or for theadministration of general anaesthesia.

In the apparatus according to the invention, the assembly comprises twoT-members for the connection of units for manual air feeding, rearwardlyof or downstream of the vaporizer and for the connection of a breathingbag forwardly of upstream of the vaporizer, both having switchingpossibilities; the assembly comprises also a third shutting-offT-member, with a switch, permitting the lateral or continuous feeding ofthe administering circuits.

To the shut-off T-member of the assembly one can connect circuits foranaesthesia and respiratory reanimation, namely a known semi-openadministering circuit, provided with a self-occluding valve or a newclosed or semi-closed administering circuit provided, with aself-occluding valve.

Instead of the latter circuit it is possible to connect other knowncircuits, according to the clinical requirements of the respective case.

The various members of the assembly as well as the components of thevarious circuits used, are provided with means for rapid assembling anddisassembling, which permits the replacement and the multiple use,respectively, of some of the members.

The apparatus, according to the invention, permits the administration ofanaesthesia with medicinal gases and anaesthetic vapors, on the mask orendotracheally, to adults or children; the administration of anaesthesiacan be effected also in the absence of medicinal gases, using as thecarrier anaesthetic atmospheric air also permits. The apparatusrespiratory reanimation with air or oxygen. Thanks to these multipletechnical possibilities the apparatus has, consequently, a multipurposecharacter.

The three T-members with respective switches, enable a rapid change overfrom one mode of administration to another. The new closed orsemi-closed circuit extends, the field of utilization of theself-occluding values. It is lighter than the closed filtering circuitsof the art and can work in any position.

DESCRIPTION OF THE DRAWING FIG. I is a vertical elevational view, partlyin diagrammatic form of an anesthesia and respiratory reanimationapparatus according to the invention;

FIG. 2 is a view similar to FIG. 1 showing various possibilities ofmodifying the system of FIG. 1;

FIG. 3 is a longitudinal section, in a vertical plane, through theshutting-off T-member which is the terminal member of the assembly andwhich serves also for the feeding of the circuits;

FIG. 4 is a cross section, in vertical plane, through the T-member inFIG. 3;

FIG. 5 is a flowing diagram of the closed or semiclosed administeringcircuit, with self-occluding valve;

FIG. 6 is a side view of the support on which the apparatus isdetachably mounted, in its wall version;

FIG. 7 is a front-elevational view of the support in FIG. 6;

FIG. 8 is an overall side view of the apparatus mounted on the wallsupport shown in FIGS. 6 and 7;

FIG. 9 is a flow diagram of the apparatus in the system in which it isused for respiratory reanimation with all;

FIG. 10 is a flow diagram of the apparatus in the system in which it isused for the administration of general anaesthesia with anaestheticvapours carried by atmospheric air;

FIG. 11 is a flow diagram of the apparatus in the system which enablesintervention with atmospheric air when medicinal gasstops;

FIG. 12 is a flow diagram of the apparatus in the system used forrespiratory reanimation with oxygen;

FIG. 13 is a flow diagram of the apparatus in the system used forcarrying out anaesthesia with medicinal gases and anaesthetic vapors insemi-open circuit;

FIG. 14 is a flow diagram of the apparatus in the system used forcarrying out anaesthesia with the circuit of FIG. 5 and with knowncircuits;

FIG. 15 is a flow diagram of the circuit in FIG. 5 working in theinspiratory phase;

FIG. 16 is a flow diagram of the circuit of FIG. 5 working in theexpiratory phase.

SPECIFIC DESCRIPTION The apparatus consists of two main parts (FIG. 2):the assemblyA for the feeding of fluids to the circuits, and theadministering circuits B.

The feeding assembly, represented in FIG. 1 comprises a support with abase plate 1, columns 2 and an upper gliding cross-bar 3, on which thecomponent pieces are slidably.

To the cross-bar 3 is brought the pipe 4 with a stop cook, for theemergency feed of oxygen, which is assembled with a block 5 for themixing of the delivered gases and for the fastening of the flowmeters tothe cross-bar 3; to the block 5 is connected the adjustable oxygenflowmeter 6 and the'adjustable nitrous oxide (nitrogen protoxide)flow-meter 7. These gases are supplied from cylinders or from a centraldistributing facility, through fittings 8 and 9, at the connecting pipes10 and 11,. respectively. The connecting fitting 12 is screwed intoblock 5. To the connecting filting joined in order: the'T-connector 13,.having a switching lever and a vertical branch 14; the vaporizer 15,which is also secured to the cross-bar 3; the uni-directional valve 16,the T-piece 17, identical with piece 13, with the vertical branch 18;the feeding assembly terminates with the shutting-off T-piece 19,secured to cross-bar 3 and provided with a switching lever, permittingthe alternating shutting-off of the vertical branch 20 and of thehorizontal branch with a flexible connecting tube, 21.

The various pieces are secured to the cross-bar 3 by means of screws,which are penetrating the slide-way thereof and are fastened at the backside with nuts. The assemblies of the line of pieces 13, 15-17 and 19are made with assembling cones.

In case of need, the feeding assembly A may comprise two vaporizers, fordiffering liquids.

The feeding assemblyA may be quipped, according to FIG. 2, as follows tobranch 14 of T-piece .13, can be mounted a selfinflatable bag 22,provided with an inlet valve 23, directly or through the agency of asleeve 24 and of a short corrugated tube 25;

also to branch 14 can be mounted, in another version, by means of theshort corrugated tube23, the respiratory bellows 26, provided with aninlet valve 27 and an outlet valve 28; I t

to branch 18 of T-piece 17 one can mount directly the respiratory bag29;

to branch 20 of the shut-off T-piece 19 one can mount a long corrugatedtube 30, followed by piece 31, with an over-pressure (relief) valve andby the self-occluding valve 32, with an inspiratory branch 33, anexpiratory branch 34 and an administering branch 35, provided insidewith a valvelet 36; to branch 35 is assembled the face mask 37 or theconnector of the endotracheal tube 38; these pieces, connected to branch20 form a semi-open administering circuit.

The shut-off T-piece 19 with its vertical branch 20 and its horizontaltube connection 21, is presented in more detail in FIGS. 3 and 4; itcomprises the horizontal cylindrical body 19, with a conical end to beassembled to T-piece 17.and with a bottom at its other end. Inside is acylindrical valve 39, also with a bottom that can be rotated integrallywith lever 40, which ensures alternately, in one position, thecommunication with connection 21 and, in another position, thecommunication with the vertical branch 20, through the openingsrepresented in the two figures. f

To tube connection 21 is mounted a rubber tube 41 to which are connectedthe known administering circuits or, preferably, the new closed orsemi-closed administering circuit with seIf-occluding valve.

The latter circuit, represented in FIG. 5, consists of: a soda limecanister 42 with a sight hole 43 for the observation of the colour ofthe soda lime; to one of the connection sleeves of the canister isassembled the cross-piece 44 with the connection sleeves 45, 46 to thecircuit, with the lateral branch 47, within which is the overpressurevalve 48, and with the lateral branch 49, to which can be mounted,either the respiratory bag 50 or the long corrugated tube 51 and therespirator 52, working in closed circuit. To the connection sleeve 46 ofthe cross-piece 44 is mounted the long corrugated tube 53, to the otherend of which is mounted an elbow 54, to which is assembled theself-occluding valve 32 by its inspiratory branch 33; to its expiratorybranch 34 is assembled an elbow 55, to which is mounted a longcorrugated tube 56, the other end of which is mounted to piece 57 forthe feeding of the circuit, provided with connexion sleeve 58 for itsassembling to canister 42, as well as with the lateral connection sleeve59, to which is connected the flexible tube 41, the other end of whichis mounted to tube connection 21 of the shutoff T-piece 19. To thebranch 35 for administering and connectingto the patient, of theself-occluding valve 32, is assembled either the face-mask 37 or theconnector 38 of the endotracheal tube.

The apparatus may be constructed also in a version to be fixed to thewall. This is achieved by means of the support presented in FIGS. 6 and7. The support is formed of a rectangular frame 60, whose upperhorizontal side 6lconstitutes a gliding cross-bar. On the vertical sides62=of the support are secured the fixing and sliding pieces 63, withscrews 64, of the frame, on the metal bar 65, with its ends embedded inthe wall. To the lower horizontal side 66 is fastened underneath theforked support 67, for the sustainment of the closed or half-closedcircuit with self-occluding valve.

above circuit B is presented in FIG. 8, mounted on the wall supportshown in FIGS. 6 and 7.

A suction nozzle 68 is mounted laterally on the side 62 of the frame,for the aspiration of the secretion of the patient.

The portable, multipurpose apparatus for anaesthesia and respiratoryreanimation permits the performing of the following operations:

a. Respiratory reanimation with air in the absence of 10 medicinalgases. The assemblage required is shown in FIG. 9. To the verticalbranch of T-piece 13 is mounted the short corrugated tube 25, the sleeve24 and the self-inflating bag 22, with the valve 23. The T-piece 13'isin an open position, while the val5 porizer 15 and the T-piece 17 areclosed. T-piece 19 is open towards branch 20, to which is mounted theknown semi-open administering circuit.

By pressing the self-inflating bag 22, the air existing within passesthrough assembly A and the mounted 20 semi-open circuit and isadministered, through the agency of face-mask 27 or of the connector ofthe endotracheal tube 38, to the patient. Immediately as the pressing onthe bag 22 ceases, the position of the valvelet 36 of the respiratoryvalve 32 changes and the air 25 from the lungs of the patient isevacuated into the atmosphere, through the expiratory branchd 34. At thesame time, the self-inflating bag 22 returns to its original form, bythe aspiration of the air outside, through valve 23 after which thecycle is repeated. The overpressure valve 31 avoids the creation of adangerous positive pressure in the circuit, during the inspiratoryphase.

Instead of the self-inflating bag 22, one can mount and use therespiratory bellows 26, with its valves. 35

In the presence of contaminated air, it is possible to apply to thesuction of bag 22 a filtering element, not shown in the scheme.

b. Administration of general anaesthesia by means of anaesthetic vapourscarried by air. One uses in this case the assemblage presented in FIG.10, similar with that described in the preceding point, with a vaporizerwhich opposes a slight resistance to inspiration. One can use, possibly,a vaporizer that can be used successively for variousanaesthetic'liquids.

Anaesthesia may be administered on the mask or endotracheally. After theanaesthesia is stabilized and the patient breathes spontaneously, theself-inflating bag 22 or the respiratory bellows, respectively, may beremoved and the patient can inspire directly through branch 14 of theT-piece 13, the inspired air passing through vaporizer 15.

through the flow-meters 6 and 7, one mounts the tube 65 and the sleeve25, 24 and the bag 22. The air from within the bag 22 is pushed throughassembly A; it passes through vaporizer l5 and accumulates in therebrated vaporizer 15.

d. Respiratory reanimation with oxygen. To this end,

the apparatus is connected to an oxygen source, realizing thus theassemblage shown in FIG. 12. The T-piece l3 and the vaporizer 15 are inshutoff position. To branch 18 of T-piece 17, being in open position, ismounted the respiratory bag 29. To T- piece 19, open towards branch 20,is mounted the semi-open administering circuit.

The oxygen fed in initially through the pipe with a cock 4, then throughthe oxygen flowmeter 6, passes through the assemblage and accumulates inthe respiratory bag 29. By the compression thereof, the oxygen passesthrough the semi-open circuit, to the patient, valvelet 36 shutting offthe expiratory orifice 34; the unidirectional valve 16 impedes areversal of the gaseous flow. In the expiratory phase, valvelet 36 shutsoff the inspiratory branch 33 of valve 32, while the bag 29 re-fillswith oxygen.

e. Administration of anaesthesia with oxygen and nitrous oxide and withanaesthetic vapours in semiopen circuit. One uses the assemblage in FIG.13, similar with that in FIG. 12, in which is open also the nitrousoxide feed, through flow meter 7, while the mixture of medicinal gasespasses also through the vaporizer 15. Administration takes place in theway described in point d.

f. Anaesthesia with the new administering circuit, with self-occludingvalve, working in closed or semi-closed circuit or with knownanaesthetic circuits. The mounting shown in FIG. 14 is realized,completed with the selected anaesthetic circuit. The T-pieces l3 and 17are shut off, while T-piece 19 is open towards connection sleeve 21.

The feeding of oxygen and nitrous oxide is made through flowmeters 6 and7, the mixture of which passes through the vaporizer 15, and, chargedwith anaesthetic vapours, arrives in the anaesthetic circuit through theflexible tube 41.

g. Working of the closed or semi-closed circuit for ananaesthesia orrespiratory reanimation, provided with self-occluding valve. In the.inspiratory phase, represented in FIG. 15, the gas mixture, fed-inthrough tube 41, passes through the canister with soda lime 42, andaccumulates in the respiratory bag 50. In case of spontaneous breathingof the patient, the gas mixture passes through the crosspiece 44, thecorrugated tube and arrives, through the self-occluding valve 32, withthe valvelet 36, shutting off the expiratory branch 34, at the patientthrough the face mask 37 or the connector of the endotracheal tube 38.In the expiratory phase, represented in FIG. 16, valvelet 36 shuts offthe inspiratory branch 33 of valve 32, while the expired gaseous mixturepasses through the expiratory branch 34, the corrugated tube 56, thepiece 57 where it mixes with fresh gaseous mixture, passes throughcanister 42, where the expired carhon-dioxide is absorbed; furtherthrough the crosspiece 44 and accumulates in the respiratory bag 50. Thedescribed cycle is repeated identically when working in closed circuit.In working with semiclosed circuit, the excess gaseous mixture is ventedinto the atmosphere by the overpressure valve 48.

In case of using controlled breathing, the respiratory bag 50 isreplaced by the corrugated tube 51 and the anaesthesia respirator 52,working in closed circuit. Gas circulation in the described circuit,with closed and semi-closed operation, remains the same.

The application of the invention results in the following advantages:

one disposes of a multipurpose anaesthesia and respiratory reanimationapparatus, that can be used both in the hospital and outside it, in thepresence or in the absence of medicinal gases, in all clinicalsituations occurring, both in adults and children;

the apparatus is lighter, with pieces that can be readily assembled-anddisassembled; it is of multiple use, being executed in a portableversion and in a detachable version to be fixed to the wall.

We claim:

1. An apparatus for administering an anaesthetic and for respiratoryreanimation comprising:

a support;

a gas-mixing assembly mounted on said support and provided with an inletand an outlet and a main flow path therebetween for at least one gasadapted to be administered to a patient;

at least two T-fittings detachably connected in series with one anotherand to said assembly on said support, each of said fittings having amain flow path connected in series with one another and with the mainflow path of said assembly, a branch extending laterally from therespective main flow paths of said fittings and respective selectivelyoperable closure members for selectively effecting communication betweenthe respective branch and main flow path;

a vaporizer detachably connected between said fittings on said supportand in series with the main flow paths thereof;

a shutoff fitting detachably connected to the main flow path of saidT-fittings downstream thereof and provided with a selectively operableflow-blocking closure member;

an administering mask system detachably connected to said shutofffitting, and

respective inflatable bags detachably connectable to said branches.

2. The apparatus defined in claim 1 wherein each of said fittingscomprises a cylindrical body defining the main flow paths-thereof andprovided with formations at least at one end for detachable connectionto other elements of the apparatus, and said closure members eachinclude a cylindrical sleeve rotatably received in the respective bodyand provided with a lateral opening, and a lever projecting from therespective body and affixed to the respective sleeve for rotating sameabout its axis, said bodies each having anarcuate slot receiving therespective lever.

3. The apparatus defined in claim 1 wherein said support comprises abase, a pair of columns spaced apart and extending upwardly from saidbase, and a crossbar receiving elements of said apparatus including saidassembly, said fittings and said vaporizer, said gas-mixing assemblyincluding:

a mixing block mounted on said crossbar;

an oxygen flow meter extending between said base and said block;

a nitrogen protoxide flow meter extending between said base and saidblock; and

an emergency-oxygen duct provided with a valve and extending betweensaid base and said block.

4. The apparatus defined in claim 1 wherein said support comprises aframe adapted to be affixed to a wall and means for mounting saidassembly, said fittings and said vaporizer on said frame.

5. The apparatus defined in claim 1 wherein said administering masksystem comprises a single elongated conduit detachably connected to saidshutoff fitting at one end thereof and a mask having an exhalation portto the atmosphere attached at the other end of said elongated conduit,whereby the closure members are operated to communicate the branches ofthe T-fittings with the main flow path providing for an open system.

viding for a closed system.

1. An apparatus for administering an anaesthetic and for respiratoryreanimation comprising: a support; a gas-mixing assembly mounted on saidsupport and provided with an inlet and an outlet and a main flow paththerebetween for at least one gas adapted to be administered to apatient; at least two T-fittings detachably connected in series with oneanother and to said assembly on said support, each of said fittingshaving a main flow path connected in series with one another and withthe main flow path of said assembly, a branch extending laterally fromthe respective main flow paths of said fittings and respectiveselectively operable closure members for selectively effectingcommunication between the respective branch and main flow path; avaporizer detachably connected between said fittings on said support andin series with the main flow paths thereof; a shutoff fitting detachablyconnected to the main flow path of said T-fittings downstream thereofand provided with a selectively operable flow-blocking closure member;an administering mask system detachably connected to said shutofffitting, and respective inflatable bags detachably connectable to saidbranches.
 2. The apparatus defined in claim 1 wherein each of saidfittings comprises a cylindrical body defining the main flow pathsthereof and provided with formations at least at one end for detachableconnection to other elements of the apparatus, and said closure memberseach include a cylindrical sleeve rotatably received in the respectivebody and provided with a lateral opening, and a lever projecting fromthe respective body and affixed to the respective sleeve for rotatingsame about its axis, said bodies each having an arcuate slot receivingthe respective lever.
 3. The apparatus defined in claim 1 wherein saidsupport comprisEs a base, a pair of columns spaced apart and extendingupwardly from said base, and a crossbar receiving elements of saidapparatus including said assembly, said fittings and said vaporizer,said gas-mixing assembly including: a mixing block mounted on saidcrossbar; an oxygen flow meter extending between said base and saidblock; a nitrogen protoxide flow meter extending between said base andsaid block; and an emergency-oxygen duct provided with a valve andextending between said base and said block.
 4. The apparatus defined inclaim 1 wherein said support comprises a frame adapted to be affixed toa wall and means for mounting said assembly, said fittings and saidvaporizer on said frame.
 5. The apparatus defined in claim 1 whereinsaid administering mask system comprises a single elongated conduitdetachably connected to said shutoff fitting at one end thereof and amask having an exhalation port to the atmosphere attached at the otherend of said elongated conduit, whereby the closure members are operatedto communicate the branches of the T-fittings with the main flow pathproviding for an open system.
 6. The apparatus defined in claim 1wherein said administering mask system comprises a closed loop breathingcircuit whereby the closure members are operated to preventcommunication between the branches of the T-fittings and the main flowpath providing for a closed system.